To Medicate or Not To Medicate ADHD?

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This is a question that parents struggle with once they receive an ADHD diagnosis for their child. For some parents, it is out of the question. Some are open to the idea, while others may want more than just medication.

What is the ‘right’ thing to do? Is there a ‘right’ thing? The answer, unfortunately or fortunately, is no. There are several variables to consider when deciding the appropriate course of treatment for your child and your family, as this decision is a family affair.

What is the impact on my child’s daily functioning?

This question refers to how much your child is affected by poor focus, hyperactivity or impulsivity. That is, is your child able to establish and maintain friendships? Is your child able to take in class lessons and learn? Is your child distracting himself or others in the classroom?

Is your child able to participate in a family dinner at home by remaining seated and following a conversation? Is your child able to be in a restaurant and follow general behavioral etiquette? Is your child able to play with another child in her home without breaking things/toys? Is your child clumsy or accident prone?

Your decision will be based on how severe the level of impact is on your child’s ability to participate in daily activities and events as an individual, and for you as a family.

Are there other strategies I can use before trying medication?

Yes, there are. You can begin to implement behavioral strategies regarding homework, for example, by creating a space for your child to complete homework that is not at the kitchen table – as your kitchen is likely the “Grand Central Station” of your house, as it is in many.

It is also helpful to implement a no phone or iPod/iPad rule in your house while homework is being completed. All electronics are to be turned in to a central place in your home where you can monitor their presence during homework time.

Consistency, consistency, consistency is also helpful as a strategy. Used on a regular basis, it will ultimately become habit. Good habit.

There are many strategies to choose from, but the ones that you’ll be implementing will be based on the areas of need for your child and for you as a family. Start small and expand the behavioral expectation as your child is experiencing success.

What types of medications are out there?

Do your research. Ask questions. If you are interested in trying medication, do so for a month’s duration. Don’t go based on your observations alone, but ask others to help you notice if there is an improvement. For example, get your cub scout leader, your soccer coach, your child’s teacher(s) to offer their feedback. Also, ask your child about his experience.

In terms of the types of medications, there are stimulants, non-stimulants, short-acting and long-acting. There is also a patch as a route of administration for medication. There are advantages and disadvantages to all of these medications if you choose to go that route.

Here is what I’ve seen used for children in middle school and high school:  a long acting medication during the school day, and then a short-acting medication to get through homework and after school activities.  Timing is set just right so that the medication wears off 1-2 hours prior to bedtime and your child is able to settle down and fall asleep.

Another key point I want to make here is that medication is only one form of treatment, but it doesn’t teach your child the skills that he needs to succeed in life. Even though you may be facing pressure from your child’s teacher or Child Study Team Case Manager to start a course of medication to help manage inattention, hyperactivity or impulsivity, the medication alone will not help your child to organize school materials or manage time.

The other part of helping your child is to find a Psychologist or ADHD Coach who can help teach your child the executive functioning (EF) skills she needs to slow down, self monitor, and use strategies to help remember homework assignments and after school activities.

Question 2

You, the parent(s), are also part of the treatment. If you are an organized person who is able to begin and complete a task without hesitation, you are likely struggling in understanding why your child just can’t sit down and complete three math problems, or put on her shoes without being distracted multiple times.

I’ve seen many parents become frustrated, despite being very sympathetic towards their child. However, by providing you, the parent, with small short-term goals for your child and for you as a family, you will experience success as a whole and work towards finding a balance between what your child needs to succeed and what your family needs to function.

Whether or not to give your child medication following an ADHD diagnosis is a tough decision. Ask yourself the questions listed above and answer honestly. Whatever your decision for your child’s treatment, keep in mind that no decision is final. If you so choose to try medication, you can decide to come off of it if you feel that it isn’t working. You can also take a ‘holiday’ where you don’t give your child medication on weekends or during school breaks. You may also wish to pursue behavioral modification strategies with the help of a Psychologist or ADHD Coach, with or without medication.

Whichever course of treatment you choose, you will need to assess and re-assess and re-assess again continuously as your child’s academic, social and physiological needs will change. Don’t do this alone – work closely with a Psychologist or ADHD Coach to help you make those decisions along the way.

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Dr. Liz Matheis is a licensed clinical psychologist and certified school psychologist who specializes in treating children with ADHD, Autism, Anxiety, and learning disabilities. She created the ACHIEVE program to coach students with ADHD to create organizational systems that work for them. Dr. Liz serves as Parent Coach, in which she helps parents develop boundaries and maintain consistency in the home environment. She has been effective in helping to decrease anxiety in children, adolescents, and adults using Cognitive Behavioral Therapy techniques. She is also a sought-after contributor to numerous publications, blogs and radio shows!

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